Complex Trauma is the Key

The growing science of child development and trauma should cause us to examine all of our practices and policies if we claim to be working in the best interests of children. Within Child Welfare much policy is built on the framework of either key VALUES (e.g. “Kids need to be in school so they learn how to get along with others”), or they are built from a RIGHTS orientation – what are the child’s rights, the parent’s right, etc. While both of these are important and have their place, I believe that what we are learning from brain science and how trauma interferes with a child’s development, this frame of reference needs to have a much more central role in guiding policy and practice.

Over the past two decades, there has been a growing interest in complex trauma, or otherwise known as complex developmental trauma. This refers not just to, (1) the compounding effects of multiple types of trauma and stressors on children’s lives, but (2) to the fact that trauma has a significant effect on the child’s developing brain systems. Complex trauma, or traumatic stress, can seriously interfere with brain and nervous system development and does so in an amazingly broad way, affecting not just a child’s behaviour or thinking, but rather almost every developing system in their bodies and brains (see for example Anda et al., 2006; Kisiel et al., 2014; Perry, 2006; Perry, 2009).

The NCTSN report says:

Everyone pays the price for childhood trauma. Children, families, neighborhoods, schools, communities, service systems, and—not least of all—taxpayers are all negatively affected when childhood trauma is left unaddressed. Untreated child trauma is a major contributing factor in many of the most pressing problems that communities face—problems for which policymakers are held accountable. These include poverty, crime, low academic achievement, addiction, mental illness, and chronic medical illnesses. The cost of these problems is felt not only in human terms, but also in dollars and cents. As detailed throughout this report, billions of dollars are spent each year in the United States to address the impact of child trauma (pg. 9)

The Risks

Let’s look at a few key facts about kids in our foster care systems

A recent study indicated that over 70% of kids in foster care had experienced complex trauma – defined as multiple experiences of physical or sexual abuse, neglect, emotional abuse, or domestic violence (Greeson, 2012). This study did not count coming into foster care as a trauma, or attachment losses, or living with a parent with mental illness, or many other situations that cause traumatic stress. My assumption is that the corrected figure would be at least 90%.

This trauma often affects their brain and nervous systems, their ability to regulate emotions and behaviour, learning, attachment, and identity.

According to the Adverse Childhood Experiences study (see https://acestoohigh.com), multiple adverse experiences like these have lifetime consequences in all areas of health and psycho-social development. The lifetime costs of ACEs to society have been calculated to be about $250,000 per person on average. These figures would be much higher for children already in the foster care system.

Though these statistics are a little overwhelming, there is fantastic news that is evolving from the science of neuroplasticity. If there is any time in life when the effects of complex trauma and ACEs can be reversed it is in childhood and adolescence. However, our approaches and interventions need to be informed by, and evaluated through, the science of complex trauma and brain development. Complex trauma is at the centre of these children’s lives. If we don’t place this knowledge at the centre of our policies and programming then we are doing these children a grave disservice.